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目的分析肝结核的CT表现,探讨CT在肝结核诊断和鉴别诊断中的价值,提高对本病的认识。方法回顾性分析10例经手术、穿刺活检或临床证实的肝结核的CT资料。结果10例肝结核中,局限型肝结核6例,共12个病灶,均为低密度病灶,增强扫描:动脉期10个病灶无强化或边缘轻度强化,门脉期和(或)延迟期病灶均有不同方式的强化,10个病灶为边缘环形强化,2个病灶为分隔强化;粟粒型肝结核4例,表现为肝弥漫性肿大、密度减低或肝肿大伴有多发性粟粒状低密度灶,增强扫描无明显强化。本组6个病灶内或边缘见不同形状钙化。结论螺旋CT平扫及多期动态扫描是诊断肝结核的有效影像检查方法之一,结合临床资料及其他影像检查结果综合分析;可明显提高诊断准确率。
Objective To analyze the CT manifestations of hepatic tuberculosis and to explore the value of CT in the diagnosis and differential diagnosis of hepatic tuberculosis so as to improve the understanding of this disease. Methods Retrospective analysis of CT data of 10 cases of liver tuberculosis confirmed by surgery, biopsy or clinically confirmed. Results Among the 10 cases of hepatic tuberculosis, 6 were localized hepatic tuberculosis, with a total of 12 lesions, all of which were low-density lesions. Enhanced scanning showed no enhancement or marginal enhancement of 10 lesions in the arterial phase, portal phase and / or delayed phase Lesions were enhanced in different ways. Ten lesions were marginal annular enhancement and two lesions were enhanced by segregation. Miliary tuberculosis was observed in 4 cases, with diffuse enlargement of liver, reduction of density or hepatomegaly accompanied by multiple miliary-like low Densified lesions, enhanced scan no significant enhancement. This group of 6 lesions or edge see different shape calcification. Conclusions Spiral CT scan and multi-phase dynamic scanning are one of the effective methods to diagnose hepatic tuberculosis. Combined with clinical data and other imaging results, the diagnostic accuracy can be significantly improved.